A message to physicians and other health care providers from Marin County's Public Health Officer.

Flavored Tobacco and Vaping

E-cigarette use among youth is increasing in Marin, threatening years of progress in tobacco control. The number of Marin County 11th-graders who reported vaping regularly rose from 11 percent in 2016 to 28 percent in 2018. The use of flavored tobacco, such as menthol cigarettes and flavored cigars, is also increasing among youth and these products are aggressively marketed in African-American communities. On October 30, the Marin County Board of Supervisors unanimously supported the Public Health Department's request to consider a local ban on the sale of flavored tobacco products. The vote will be held November 6.

Acute Flaccid Myelitis

Since early October, there has been a growing number of cases of acute flaccid myelitis (AFM) across the United States. No cases have yet been reported for Marin County. AFM is a rare neurological condition that primarily occurs in children, characterized by sudden onset of weakness in one or more limbs and abnormalities of the spinal cord gray matter on magnetic resonance imaging (MRI). Some cases are testing positive for enteroviruses A71 and D68. Clinicians should contact Marin County Communicable Disease Prevention and Control (CDPC) if they suspect AFM at 415-473-4163. CDPC will coordinate specimen collection (CSF, serum, stool, and NP/OP) and laboratory testing.

Child Lead Poisoning Prevention

October celebrates National Lead Poisoning Prevention Week. Vigilant screening for lead exposure enables early treatment and can identify environmental sources. Lead poisoning is a highly preventable environmental disease in young children. Marin County Public Health recommends that all children be assessed for potential lead exposure, especially recent immigrants. In addition, the California Department of Public Health mandates blood lead screening at 12 months and 24 months for all children in public programs such as Medi-Cal, CHDP, and the Women Infants and Children (WIC) Program. Please direct any questions to the Childhood Lead Poisoning Prevention Coordinator, Laurel Johnson, RN, at 415-743-4294.

Norovirus Is Coming

Every fall, Marin County experiences a surge in gastrointestinal illness, primarily focused in schools and congregate living settings. Norovirus, the most common form of seasonal gastroenteritis, is highly contagious and is transmitted by direct contact with an infected person; consuming contaminated food or water; and hand-to-mouth contact. Symptoms often only last for one day, but cases are infectious for 48 hours after symptoms resolve. To learn more about norovirus, and for instructions on reporting outbreaks, visit the Marin County Communicable Disease Prevention and Control (CDPC) webpage.

Message from the Public Health Officer

With all the progress that's been made in tobacco control, it's easy to forget that tobacco remains the leading cause of preventable death in the United States. Every day, more than 1,000 Americans die from tobacco-related disease --- more than the sum of most public health priorities, including gun violence, suicide, HIV and opioids combined. For decades, it has taken policy and legislation to protect our communities from tobacco-related harm. This newsletter highlights one way our elected officials are responding, thanks in part to your voice as clinicians who see the consequences of nicotine addition every day. Clinicians or others who would like to voice their support can email to BOS@marincounty.org